Long Term Care for Activity Professionals, Social Services Professionals, and Recreational Therapists, Sixth Edition
Elizabeth Best-Martini, Mary Anne Weeks, and Priscilla Wirth
Trade Paper, Reproducible Forms, 432 pages
Published by Idyll Arbor
Publication date: 2011
ISBN: 9781882883899

MDS 3.0 has brought many changes to long-term care. Even in facilities that are not required to meet OBRA standards, there are changes underway to meet the goals of person-centered programming. The sixth edition of Long-Term Care covers these changes and provides you with the information you need to provide outstanding care for your residents and participants.

The book is down to earth and easy to understand. It will to answer your difficult questions about working with diverse resident groups, meeting standards, working with team and family members, and managing your department. It lets you see how all the parts of long-term care facilities, assisted living facilities, and adult day programs can fit together to make an empowering, healthful environment for everyone. It shows you how to provide care that satisfies, and even exceeds, health care regulations. It's a great reference book with many excellent activities and reproducible forms!

The sixth edition includes information on how to pass the new survey procedures and more details on successful person-centered programming. This is the best reference book for activity directors in long-term care facilities. It is the most popular text for training new activity professionals and is recommended as a study guide for the National Association of Activity Professionals Credentialing Center certification exam.


Table of Forms viii
Index of Activities ix
Acknowledgments xi
Purpose xiii

1. Introduction 1
Culture Change in Long-Term Care 1
The Settings in Which We Work 3
What's in this Book 7
Terminology 9

2. The People We Serve 11
Theories on Aging 11
Demographics of the People We Serve 14
Myths and Realities of Aging 2000 17
Older Americans Act 19
Imagine Yourself at 84 19
Dealing with Now 21
Reactions to Illness 22
The People We Serve and Their Families 23
Barbara's Story 32
Diagnosis and Chronic Disorders 34
MDS List of Active Diagnoses 35
The Diagnostic Intervention Grid 36
Neurological Disorders and Psychiatric Disorders 46
The Wellness Tree of Life 49
Sensory Loss 53
Saying Goodbye: The Way We Grieve, the Way We Die 54

3. The Work We Do 57
Our History 57
Professional Organizations 60
Professionalism 61
Activity Professional 62
Activity Consultation 68
Social Services Professional 68
Recreational Therapist 74
Teamwork 77

4. Environment 79
Physical Environment 79
Personal Environment 85
Cultural Environment 86
Working Environment 86
Environmental Assessment Form 87

5. Person-Centered Programs 91
Person-Centered Activity Programming 91
Discovering the Person 93
Cognitive Activity Levels 97
Physical Activity and Exercise with Older Adults 100
Physical Function and Exercises according to Common Medical Disorders 103
Activity Needs Assessment 105
Activity Review Forms 114
Social Services Review Form 118
OBRA Interpretive Guidelines Tips 121

6. Providing Meaningful Activities 123
Activity Suggestions 123
Challenges and Techniques of Group Work 124
Leisure, Leisure, Leisure 125
Leisure Room 126
Person-Centered Activities 129
Activity Supplies 129
Activity Analysis 132
One-to-One Programming 134
Multi-Sensory, Multi-Level Theme Activities 136
Theme Weeks 136
Intergenerational Programs 142

7. Programming for Individuals with Severe Cognitive Impairments 145
Programming Overview 145
Sensory Integration 146
Sensory Stimulation 150
The Sensory Box 170
Activities for Individuals with Cognitive Impairments 171

8. Programming for Individuals with Mild to Moderate Cognitive Impairments 173
Validating Activities 173
Remotivating/Reminiscing Activities 177
Resocializing Activities 179
Men in a Women's World 192

9. Short-Term Stay: Rehab-Oriented 196
Cognitive Stimulation and Retraining Activities 196
Short-Term Rehab Activities 213
Community Integration Activities 216

10. Documentation 218
Documentation Principles 219
Introduction to Required Documentation 220
Activity Documentation 223
Social Services Documentation 224
Recreational Therapy Documentation 225

11. Assessments 226
Initial Assessment 226
Activity Assessment 228
Social Services Assessment 231
Recreational Therapy Assessment 235
Standardized Scales and Assessment Tools 235
Discharge from the Nursing Home 239

12. Resident Assessment Instrument and Treatment Planning 242
Purposes of the RAI 242
Overview of the RAI Process 243
Conducting the Interview 246
Care Planning 259
The MDS for Reimbursement 268

13. Monitoring the Treatment Plan 270
Monitoring Tools -- Activities 270
Monitoring Tools -- Social Services 274
Quarterly Review 274
The Care Plan 275
Annual Review 279
Other Considerations for Documentation 280
Health Insurance Portability and Accountability Act (HIPAA) 285

14. Councils 286
Resident Council 286
Family Council 294

15. Volunteers 297
Activity Department Volunteers 297
Social Services Volunteers 298
One-on-One Friendship Programs 299

16. Quality Assurance, Infection Control, and Risk Management 300
Quality Assurance 300
Infection Control 307
Risk Management 308
Immediate Jeopardy 310

17. Management 313
Resident's Rights 313
Restraints 322
Behavior Management 323
Time Management 333
Budgets 335
Policies and Procedures 336
OBRA Regulations 338
Surveys 345
Survey Groups 349
Medications in the Elderly 356

18. Summary 359
A. Abbreviations 361
B. Minimum Data Set and the Resident Assessment System 363
C. Care Area Assessments 403
References and Further Reading 421
Index 425

Elizabeth (Betsy) Best Martini is a Certified Recreational Therapist specializing in the field of gerontology, and long term care. She has a Master of Science Degree in Recreation Therapy / Administration. She also has a State of California RCFE Administrator Certificate as a licensed administrator for assisted living settings.

Betsy has a consulting firm, Recreation Consultation & Best Solutions, that provides recreational therapy consultation to retirement communities, skilled nursing settings, sub-acute settings, state hospitals, cities and counties and residential / assisted care facilities in Northern California.

For more information see her web site: www.BetsyBest.com

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